Cytisine on par with nortriptyline for smoking cessation

Treatment with cytisine shows comparable efficacy to that of nortriptyline for smoking cessation at 1 year, according to a study. In addition, adverse events for both medications are few and well-tolerated.

A total of 1,086 participants were included in this multicentre, randomized, double-blinded, placebo-controlled trial. Individuals aged ≥20 years who smoked at least 10 cigarettes per day were randomly assigned to receive a 25-day cytisine (n=540) or a 12-week nortriptyline (n=546) treatment course. All participants also received brief interventions (BI) for smoking cessation.

The authors collected self-reported abstinence, verified by exhaled carbon monoxide (CO) ≤10 ppm, at 2 weeks, 1, 3, 6, and 12 months to evaluate the continuous abstinence rate (CRA), the primary outcome, and 7-day point prevalence abstinence rate (PAR).

CAR at 12 months was higher in the cytisine group than the nortriptyline group (12.22 percent vs 9.52 percent), with a relative difference of 0.03 (95 percent confidence interval [CI], ‒0.01 to 0.06) and a relative risk of 1.28 (95 percent CI, 0.91‒1.81).

No significant between-group difference was seen in PAR. Moreover, participants who received cytisine appeared to experience fewer adverse effects than those treated with nortriptyline.

“Cytisine serves as an affordable smoking cessation aid with acceptable safety profile,” the authors said.